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[PMID]: 29523922
[Au] Autor:Wittekind S; Mays W; Gerdes Y; Knecht S; Hambrook J; Border W; Jefferies JL
[Ad] Address:Cincinnati Children's Hospital Medical Center, Heart Institute, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH, 45229-3026, USA. Samuel.Wittekind@cchmc.org.
[Ti] Title:A Novel Mechanism for Improved Exercise Performance in Pediatric Fontan Patients After Cardiac Rehabilitation.
[So] Source:Pediatr Cardiol;, 2018 Mar 09.
[Is] ISSN:1432-1971
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Patients with a Fontan circulation have impaired exercise capacity. Cardiac rehabilitation (CR) has shown promise in enhancing peak exercise parameters in this population, but an improvement in submaximal exercise has not been consistently demonstrated. We assessed the hypothesis that participation in CR will be associated with more efficient oxygen extraction and ventilation during submaximal exercise. In this prospective study, pediatric Fontans completed two 60 min CR sessions per week for 12 weeks. Cardiopulmonary exercise testing and stress echocardiography were performed at baseline and last CR session, and then compared with a paired sample t test. Ten pediatric Fontans completed the study. Five had tricuspid atresia and five had hypoplastic left heart syndrome. No serious adverse events occurred during CR sessions. Peak indexed oxygen consumption increased by a mean of 3.7 mL/kg/min (95% CI 1.5-5.9; p = 0.004), and peak oxygen pulse increased by a mean of 0.9 mL/beat (95% CI 0.4-1.4; p = 0.004). The peak respiratory exchange ratio did not change significantly. The significant difference in oxygen pulse became evident during submaximal exercise without a corresponding difference in echocardiographic stroke volume. Indexed oxygen consumption at ventilatory anaerobic threshold increased by a mean of 3.0 mL/kg/min (95% CI - 0.07 to 6.0; p = 0.055). The slope for the volume of expired ventilation to volume of carbon dioxide production improved by a mean of 4.5 (95% CI - 8.4 to - 0.6; p = 0.03). We observed significant improvements in both submaximal and peak exercise performance in pediatric Fontans undergoing CR with no serious adverse events. These changes appeared to be mediated, at least in part, by more efficient oxygen extraction and ventilation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s00246-018-1854-3

  2 / 3519 MEDLINE  
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[PMID]: 29480841
[Au] Autor:Chen LJ; Zhang YQ; Tong ZR; Sun AM
[Ad] Address:Department of Pediatric Cardiology.
[Ti] Title:Evaluation of the anatomic and hemodynamic abnormalities in tricuspid atresia before and after surgery using computational fluid dynamics.
[So] Source:Medicine (Baltimore);97(2):e9510, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Analysis of hemodynamics inside tricuspid atresia (TA) chamber is essential to the understanding of TA for optimal treatment. In this study, we introduced a combined computational fluid dynamics (CFD) to simulate blood flow in the left ventricle (LV) to study the diastolic flow changes in TA.Real-time 3-dimentional echocardiography loops (ECHO) were acquired in normal control group, in TA patients before surgery (pre-op group) and after surgery (post-op group). ECHO loops were reconstructed and simulated by CFD, the geometric, volumetric changes, and vortices in the LV were studies and compare among 3 groups.Compared with the control group, pre-op TA patients demonstrated significant LV remodeling, manifesting with smaller LV length, larger diameter, width and spherical index, as well as lager volumes; post-op TA group showed revisions in values of both geometric and volumetric measurements. CDF also demonstrated the abnormality of vortices in the pre-op TA patients and the alteration of existence and measurements of vortex in postoperation group.Echo-based CFD modeling can show the abnormality of TA in both LV geometric, volumetric measurements and intracardiac vortices; and CFD is capable to demonstrate the alterations of LV after Fontan and Glenn surgical procedure.
[Mh] MeSH terms primary: Heart Ventricles/diagnostic imaging
Hemodynamics
Regional Blood Flow
Tricuspid Atresia/diagnostic imaging
Tricuspid Atresia/surgery
[Mh] MeSH terms secundary: Adult
Computer Simulation
Echocardiography, Three-Dimensional
Female
Heart Ventricles/physiopathology
Humans
Hydrodynamics
Male
Models, Cardiovascular
Organ Size
Tomography, X-Ray Computed
Treatment Outcome
Tricuspid Atresia/physiopathology
[Pt] Publication type:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009510

  3 / 3519 MEDLINE  
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[PMID]: 29457852
[Au] Autor:Yamada Y; Hoshino K; Oyanagi T; Gatayama R; Maeda J; Katori N; Fuchimoto Y; Hibi T; Shinoda M; Matsubara K; Obara H; Aeba R; Kitagawa Y; Yamagishi H; Kuroda T
[Ad] Address:Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan.
[Ti] Title:Successful management of living donor liver transplantation for biliary atresia with single ventricle physiology-from peri-transplant through total cavopulmonary connection: A case report.
[So] Source:Pediatr Transplant;, 2018 Feb 19.
[Is] ISSN:1399-3046
[Cp] Country of publication:Denmark
[La] Language:eng
[Ab] Abstract:Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology. The cardiac anomalies included total anomalous pulmonary venous return type IIb, intermediate atrioventricular septal defect, tricuspid regurgitation grade III, coarctation of aorta, interrupted inferior vena cava, bilateral superior vena cava, and polysplenia syndrome. Following LDLTx, the patient sequentially underwent total cavopulmonary shunt + Damus-Kaye-Stansel at 3 years of age and extracardiac total cavopulmonary connection (EC-TCPC) completion at 5 years of age; 7 years have now passed since LDLTx (2 years post-EC-TCPC). We describe the details of the management of LTx in the presence of cardiac anomalies and report the long-term cardiac and liver function, from peri-LDLTx through EC-TCPC completion.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:Publisher
[do] DOI:10.1111/petr.13118

  4 / 3519 MEDLINE  
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[PMID]: 29455772
[Au] Autor:Bravo-Valenzuela NJ; Peixoto AB; Araujo Júnior E
[Ad] Address:Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
[Ti] Title:Prenatal diagnosis of congenital heart disease: A review of current knowledge.
[So] Source:Indian Heart J;70(1):150-164, 2018 Jan - Feb.
[Is] ISSN:0019-4832
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects. Anatomical details of most CHD in fetuses were provided by two-dimensional (2D) ultrasound with higher quality imaging, enhancing diagnostic accuracy in a variety of CHD. Moreover, the accuracy of the cardiac defects in obstetrics ultrasound improves the outcome of most CHD, providing planned delivery, aided genetic counseling, and perinatal management.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:In-Process

  5 / 3519 MEDLINE  
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[PMID]: 29174590
[Au] Autor:Kohnken R; Schober K; Godman J; Gardner A; Jenkins T; Schroeder E; Baker P; Dunbar L
[Ad] Address:Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA. Electronic address: Kohnken.1@osu.edu.
[Ti] Title:Double outlet right ventricle with subpulmonary ventricular septal defect (Taussig-Bing anomaly) and other complex congenital cardiac malformations in an American Quarter Horse foal.
[So] Source:J Vet Cardiol;20(1):64-72, 2018 Feb.
[Is] ISSN:1875-0834
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:A 4-week-old American Quarter Horse colt presented with a recent history of diarrhea and decreased activity level. On initial physical examination, the animal was bright and alert and major findings were limited to a loud systolic heart murmur radiating widely over both sides of the thorax. While in the hospital, the clinical condition of the foal warranted further imaging to determine the cause and extent of cardiac disease. A variety of congenital cardiac malformations were identified during echocardiographic examination and autopsy, including a double outlet right ventricle and a subpulmonary interventricular septal defect (Taussig-Bing anomaly), ventricular inversion with atrioventricular discordance, tricuspid valve atresia, a septum primum interatrial septal defect, mitral valve dysplasia with a cleft in the septal mitral valve cusp, aortic, and subaortic stenosis, tubular hypoplasia of the ascending aorta and the aortic arch, a patent ductus arteriosus, an aberrant circumflex coronary artery, and aberrant left and right subclavian arteries. Echocardiographic and postmortem findings of the cardiac defects in this foal are presented and discussed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:In-Process

  6 / 3519 MEDLINE  
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[PMID]: 29338918
[Au] Autor:Miranda WR; Egbe AC; Hagler DJ; Taggart NW; Nishimura RA; Connolly HM; Warnes CA
[Ad] Address:Department of Cardiovascular Diseases, Mayo Clinic, MN, United States. Electronic address: miranda.william@mayo.edu.
[Ti] Title:Filling pressures in Fontan revisited: Comparison between pulmonary artery wedge, ventricular end-diastolic, and left atrial pressures in adults.
[So] Source:Int J Cardiol;255:32-36, 2018 Mar 15.
[Is] ISSN:1874-1754
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pulmonary artery wedge pressure (PAWP) has been shown to correlate better with left atrial pressure (LAP) than ventricular end-diastolic pressure (VEDP) in acquired heart disease. The correlation between VEDP and PAWP and their performance as surrogates for LAP in Fontan patients is unknown. METHODS: Offline single-beat simultaneous measurement of PAWP and VEDP was performed in 50 adult Fontan patients and non-simultaneous hemodynamic data abstracted for calculation of pulmonary vascular resistance (PVR). For the evaluation of PAWP and VEDP as surrogates for LAP, 14 fenestrated adult Fontan patients were included. RESULTS: Mean age was 34.2±10years and 54% of patients were female. Tricuspid atresia and double inlet left ventricle were the most common congenital defects (44% and 20%, respectively). Simultaneous mean VEDP was 10.8±4.6mmHg and mean PAWP was 11±4.6mmHg; the PAWP-VEDP correlation was 0.91 (p<0.001). Using non-simultaneous data, right-sided (mean difference 0.6WU·m , 95% CI 0.2-1.0; p=0.005) and left-sided (mean difference 0.5WU·m , 95% CI 0.1-0.9; p=0.02) PVRs were significantly higher when PAWP rather than VEDP was used. In fenestrated patients, LAP-right PAWP and LAP-left PAWP correlations were 0.97 and 0.95 (p<0.0001 for both), respectively, whereas the correlation between LAP-VEDP was 0.76 (p=0.007). CONCLUSIONS: PAWP and VEDP correlate reasonably well in adult Fontan patients but PAWP is a better surrogate for LAP. The use of VEDP instead of PAWP appears to significantly underestimate PVR in these patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[St] Status:In-Data-Review

  7 / 3519 MEDLINE  
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[PMID]: 29411679
[Au] Autor:Chikkabyrappa SM; Loomba RS; Tretter JT
[Ad] Address:1 Seattle Childrens Hospital, University of Washington, Seattle, WA, USA.
[Ti] Title:Pulmonary Atresia With an Intact Ventricular Septum: Preoperative Physiology, Imaging, and Management.
[So] Source:Semin Cardiothorac Vasc Anesth;:1089253218756757, 2018 Feb 01.
[Is] ISSN:1940-5596
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare complex cyanotic congenital heart disease with heterogeneous morphological variation. Prenatal diagnosis allows for developing a safe plan for delivery and postnatal management. While transthoracic echocardiography allows for detailed delineation of the cardiac anatomy, additional imaging modalities such as computed tomography, magnetic resonance imaging, and catheterization may be necessary to further outline features of the cardiac anatomy, specifically coronary artery anatomy. The size of the tricuspid valve and right ventricular cavity as well as the presence of right ventricle-dependent coronary circulation help to dichotomize between biventricular repair versus univentricular palliation or heart transplantation, as well as predicting the expected survival. The delineation and understanding of these features help to dictate both medical and surgical management.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180207
[Lr] Last revision date:180207
[St] Status:Publisher
[do] DOI:10.1177/1089253218756757

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[PMID]: 29293486
[Au] Autor:Richtsfeld M; Konia M; Hiremath G; Kloesel B
[Ad] Address:From the Departments of Anesthesiology and Pediatrics, Division of Pediatric Cardiology, University of Minnesota, Masonic Children's Hospital, Pediatric Heart Center, Minneapolis, Minnesota.
[Ti] Title:Anesthetic Management During Atrial Septostomy in a Conjoined Thoraco-Omphalopagus Twin With Tricuspid Atresia and d-Transposition of the Great Arteries Before Separation: A Case Report.
[So] Source:A A Pract;, 2017 Dec 28.
[Is] ISSN:2575-3126
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Conjoined twins are uncommon with reported incidences of 1 in 30,000-200,000 births. They represent a heterogeneous population in regard to location of joint body parts and presence/extent of internal organ fusion. Positioning, airway management, possible presence of cross-circulation, and the fact that 2 patients require anesthesia for each procedure present significant challenges to the anesthesiologist. We report the anesthetic care of a conjoined twin set in which one of the patients presented with tricuspid atresia, d-transposition of the great arteries, and both atrial and ventricular septal defect. A balloon atrial septostomy was performed to allow survival after a separation procedure.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180206
[Lr] Last revision date:180206
[St] Status:Publisher
[do] DOI:10.1213/XAA.0000000000000691

  9 / 3519 MEDLINE  
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[PMID]: 29187115
[Au] Autor:Martin BJ; Khoo NS; Smallhorn J; Aklabi MA
[Ad] Address:1 Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
[Ti] Title:Tricuspid Valve Repair in Infancy Using Neochordae: Three-Dimensional Echocardiographic Imaging.
[So] Source:World J Pediatr Congenit Heart Surg;8(6):740-742, 2017 11.
[Is] ISSN:2150-136X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Tricuspid regurgitation (TR) in infancy poses a surgical challenge. Both two- and three-dimensional echocardiography (3DE) can provide detailed information about the mechanism(s) of valve failure and insights into valve adaptation during follow-up. We report two patients who underwent tricuspid valve repair using Gore-Tex neochordae, repairs which were facilitated by and assessed with 3DE. Both infants had less than mild residual TR and no valve tethering at hospital discharge. Furthermore, follow-up 3DEs have helped to confirm valve competence, lack of tethering, and growth of the valve and valve apparatus.
[Mh] MeSH terms primary: Cardiac Surgical Procedures/methods
Echocardiography, Three-Dimensional/methods
Polytetrafluoroethylene
Prostheses and Implants
Tricuspid Valve Insufficiency/surgery
Tricuspid Valve/surgery
[Mh] MeSH terms secundary: Chordae Tendineae
Humans
Infant
Prosthesis Design
Tricuspid Valve/abnormalities
Tricuspid Valve/diagnostic imaging
Tricuspid Valve Insufficiency/congenital
Tricuspid Valve Insufficiency/diagnosis
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Name of substance:9002-84-0 (Polytetrafluoroethylene)
[Em] Entry month:1712
[Cu] Class update date: 180202
[Lr] Last revision date:180202
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.1177/2150135117736286

  10 / 3519 MEDLINE  
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[PMID]: 29361049
[Au] Autor:Sideris K; Vodiskar J; Lange R; Cleuziou J
[Ad] Address:Department of Cardiovascular Surgery, German Heart Center Munich, Technical University Munich, Munich, Germany.
[Ti] Title:A persistent giant Eustachian valve: functional tricuspid atresia in a newborn.
[So] Source:Interact Cardiovasc Thorac Surg;, 2018 Jan 18.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Persistent right valve of the systemic venous sinus is a rare anomaly with anatomical variations. This anomaly may present as an obstructive structure that can inhibit the antegrade flow through the tricuspid valve. We report on a 4-day-old neonate who presented with pronounced peripheral and central cyanosis. Echocardiographic examination showed a giant Eustachian valve moving towards the tricuspid valve during late systole and leading to complete obstruction of the inflow. Blood flow was redirected through the persistent foramen ovale, producing a right-to-left shunt.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[St] Status:Publisher
[do] DOI:10.1093/icvts/ivy004


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